Pneumonia in Gold Coast, 1944: With Observations on Broncho-Pulmonary Anatomy

Semple, Thomas (1945) Pneumonia in Gold Coast, 1944: With Observations on Broncho-Pulmonary Anatomy. PhD thesis, University of Glasgow.

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Abstract

1. The paper relates an epidemic of respiratory infection, associated with a high pneumonia incidence, which occurred in a West African Primary Training Centre. 733 pneumonia patients were treated in the hospital during a nine months' period January till September, 1944. 2. Aetiology is discussed; the condition is compared and contrasted with other recognised forms of pneumonia: clinical, radiological, pathological studies and animal transmission experiments are described. 3. Observation and investigation suggest that the infection was primarily by a virus, spread by droplet infection, related to that of the common cold and of influenza but not identified as such. 4. Pneumonia occured as a secondary infection, apparently bacterial, in susceptible recruits, mostly primitive natives, many of whom showed evidence of malnutrition, avitaminosis and anaemia. The organism responsible for this secondary infection was not identified with certainty: it is suggested that one or more organisms normally present in the bacterial flora of the upper respiratory mucous membrane gained access to the lower passages via an inflamed mucosa: a degree of collapse of the affected area of lung was recognised as an early feature and it is thought that this deficient aeration was responsible for localisation of the pneumonia to that particular lobe or segment. 5. Response to sulphonamides was excellent. Complications were rare. Mortality rate was 0.55%. 6. A striking feature was the high incidence of associated jaundice (6.5% of the pneumonias). Possible explanations for this are discussed. 7. Such ah epidemic is less likely to occur when barrack rooms are divided into cubicles, each accommodating two or three men. 8. A modern method of nursing younger pneumonia patients is advocated, encouraging moderate exercise to abolish lobular collapse and so eliminate the prospects of chronic pulmonary disease. 9. Nomenclature of the minor forms of pulmonary inflammation requires revision and standardisation. 10. The segmental or lobular distribution of this pneumonia is stressed. Anatomy of the tracheo-bronchial tree and bronchopulmonary segments is discussed with special reference to nomenclature. Dissection and bronchographic studies, conducted with a view to clarifying certain differences of opinion on anatomy, especially of the upper lobes, are described and illustrated.

Item Type: Thesis (PhD)
Qualification Level: Doctoral
Keywords: Medicine, Epidemiology
Date of Award: 1945
Depositing User: Enlighten Team
Unique ID: glathesis:1945-79592
Copyright: Copyright of this thesis is held by the author.
Date Deposited: 04 Mar 2020 16:44
Last Modified: 04 Mar 2020 16:44
URI: http://theses.gla.ac.uk/id/eprint/79592

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